Ultrasound-guided percutaneous treatment of rotator cuff calcific tendinitis：randomised comparison between one- and two-needle procedure
（http://posterng.netkey.at/esr/viewing/index.php?module=viewing_poster&pi=121089）
Congress : ECR 2014
Poster No. : B-0046
Type : Scientific Paper
Keywords : Musculoskeletal system, Interventional non-vascular, Ultrasound, Treatment effects, Calcifications / Calculi
Authors : G. Ferrero1, E. Fabbro1, D. Orlandi1, L. M. Sconfienza2, F. Lacelli3, G. Serafini3, E. Silvestri1; 1Genoa/IT, 2San Donato Milanese/IT, 3Pietra Ligure/IT
DOI : 10.1594/ecr2014/B-0046
DOI-Link : http://dx.doi.org/10.1594/ecr2014/B-0046
Fig. 2: Calcifications: (a) Type I, (b) Type II, (c) Type III.
Fig. 11: A second needle (curved arrows) is inserted into the calcification (C) parallel...
Fig. 13: A 20-ml syringe filled with warm sterile water is connected to one of the...
Purpose
CALCIFIC TENDINITIS OF THE ROTATOR CUFF Etiology
The term “calcific tendinitis” refers to the intratendinous deposition of Calcium, predominantly Hydroxyapatite, that can affect every tendon in the body and especially the rotator cuff. This pathological condition is a dynamic process that evolves through pre-calcific and calcific (formative, resorptive, reconstitutive) stages (Fig.1). In the precalcific stage, microtraumatic factors...
Methods and materials
IRB approval and patients’ informed consent were obtained. 100 patients (77 females and 23 males, mean age 46years, range 32-70y) with RCCT (single calcification, acute/post-acute phase, no tendon tears) were randomized into two groups and were treated with two different US-guided percutaneous tecniques. Group A (50 patients; mean visual analogue scale [VAS]=7.8) was treated using an US-guided 16G double-needle technique (local anesthesia, washing...
Results
The calcifications we treated in group A were: 4 fluid, 25 soft, 21 hard (mean dimension 23±5 mm). The calcifications we treated in group B were: 6 fluid, 27 soft, 17 hard (mean dimension 21±6 mm). We have had a drop-out of 3 patients from group B (2nd needle insertion). Overall procedure duration in group A (489±88s) was significantly shorter (P<.001) than in group B (684±187s). Difference in procedure duration in group A (489±88s ) was significantly lower than in...
Conclusion
Single- and Double-needle procedures are equally effective in treating RCCT with no major complications. Double-needle procedure allows for significantly reducing treatment time and appears to be much easier when dealing with soft and hard calcium deposits. Improvement in ease of calcium dissolution with double-needle technique when dealing with harder calcifications. Single needle could be dedicated to Acute phase and Double needle for harder Chronic phase.
Personal information
G. Ferrero, Department of Radiology, University of Genoa. (giulio.ferrero@gmail.com)
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